New Jersey Senate Bill S1691

New Jersey 2022-2023 Regular Session

• Introduced: 2/28/22
• Refer: 2/28/22

Caption

Requires health insurers to cover Lyme disease.

Impact

By legislating that treatments for Lyme disease cannot be denied solely because they are considered experimental or investigational, the bill opens up access to a range of treatment options for patients. This change is expected to positively impact those suffering from Lyme disease who previously faced barriers in obtaining necessary medical care due to insurance limitations. The act is designed to enhance coverage under various types of health insurance, including individual and group plans, thereby ensuring broader access to care.

Summary

Senate Bill 1691 requires health insurance providers in the State of New Jersey to cover expenses related to the treatment of Lyme disease. The bill mandates that all relevant insurance plans, including those delivered or renewed after its effective date, provide coverage for treatments deemed medically necessary by a physician following a thorough evaluation of the patient’s symptoms and condition. This is particularly significant in light of the persistent challenges associated with Lyme disease, which is often difficult to diagnose and may require extensive treatment.

Contention

The provisions of SB 1691 are likely to spark discussions about the definitions of medical necessity and the classification of treatments as experimental or investigational. While supporters of the bill, including patient advocacy groups, argue that it is essential for ensuring timely and effective treatment for Lyme disease, opponents may raise concerns about the potential costs to insurers. The bill could lead to discussions about balancing patient needs with the financial sustainability of health insurance models.

Notable_points

The bill's language regarding insurance companies' obligations reflects a growing recognition of chronic conditions that do not fit neatly into traditional treatment paradigms. As Lyme disease continues to affect many individuals across New Jersey, this bill may represent a significant step towards adapting health coverage to accommodate evolving medical understandings and patient needs.